Incentives of Community Health Agents in Guinea-Bissau

Project Info

Principal Investigators

Pedro Vicente (Nova SBE)
Teresa Molina (Nova SBE)

Field Coordination

Mattia Fracchia

Managing Institutions


About this Project


The health sector in Guinea-Bissau faces a severe shortage of health workers and lack of access to health facilities. Therefore, the Guinean government and its national and international partners defined a national strategy to reduce maternal, infant and juvenile mortality and to increase access to basic health provisions, in which community health initiatives play a crucial role. In this context, the NGO VIDA together with the Ministry of Health created and organized a system of Community Health Agents (CHA) in the Autonomous Sector of Bissau.

CHA programs are becoming increasingly popular in sub-Saharan Africa. In recent years, community health workers have become an essential part of national and international health strategies on the delivery of health care in the region. At the same time, there is a concern that the low motivation of CHAs may threaten the potential benefits of investing in CHA programs.

This study wants to investigate to what extent a model in which non-financial incentives are offered on top of basic monetary benefits can result in a sustainable and effective system to incentivize CHAs in developing countries. First, we study incentives activating intrinsic motivation of the agents, related to the pro-social characteristics of the CHA role and non-monetary rewards targeting the extrinsic motivation of the agents, such as social recognition in the community. Second, this study wants also to test whether the dissemination of information on CHAs’ work in targeted communities could improve the effectiveness of the program. Finally, we will also devote attention to the possible complementarity between the different non-financial incentive schemes, as well as to the complementarity between incentive schemes and more informed beneficiaries.